You'd be hard-pressed to find a person in the Western world who hasn't laughed off the risk of agonizing bacterial infection in favor of a spoonful (or spatula smear) of raw cookie dough or cake batter. We know, sure, that there's raw egg in it, but the risk of actually becoming ill seems so low and so remote that it's rarely thought of as more than an old wives' tale in the modern era, like catching pneumonia if you go outside with wet hair.
The recent death of Las Vegas woman Linda Rivera, however, may breathe new life into our oft-ignored collective cookie dough fears.
Though it may seem like eons ago, in spring of 2009, Nestle issued a recall of 3.6 million packages of its popular Toll House cookie dough, which sickened more than 69 people in 25 states with E. coli. The outbreak was swept under the rug fairly quickly, and forgotten by most amongst the frequent, fleeting food-poisoning outbreaks that come and go in the media several times each year. But for Linda Rivera, it was an event that changed everything.
In May of that year, on her son's prom night, Rivera—unaware of the recall to come, or the dangers associated with something as innocuous as store-bought chocolate chip cookie dough—took what her son, Ricky Simpson, described as "a couple bites" of the cookie dough. Two days later, she became frighteningly ill, rushed to the hospital with quickly-worsening flu-like symptoms and found by doctors to be experiencing a ravaged colon, septic shock, and later on organ failure and cardiac arrest. At one point, she was in a doctor-induced coma for more than 10 days.
The strain of E. coli that she had contracted—E. coli O157:H7—was unusually nasty; though for most people it results in bloody diarrhea, stomach cramps, and vomiting, the harrowing effects for Rivera extended far and beyond an unpleasant evening spent in the bathroom.
Though doctors were initially able to eradicate the bacteria, her health problems continued for more than four years, until her eventual death in mid-2013. The remainder of her post-E. coli life was spent in and out of hospitals, and often in a bed-ridden state.
Simpson testified before an FDA panel this past Thursday, recounting in tragic detail his mother's fight for her life after such an simple act of negligence, if it can even be classified as such given the ubiquity of eating raw cookie dough. Before her death, Rivera settled with Nestle for an undisclosed amount.
Most victims of the 2009 E. coli outbreak were "teenage girls and children," making Rivera's case something of an anomaly. But the interesting part about the outbreak was that it was, as Centers for Disease Control and Prevention epidemiologist Karen Neil revealed to NPR, most likely caused by contaminated flour. The risk of contracting salmonella from raw egg is most commonly cited as the reason to steer clear of eating raw cookie dough and cake batter—not the flour. The eggs in Nestle's prepacked cookie dough are pasteurized, meaning the risk of contracting salmonella from them is even lower. But flour—well, that was a wild card.
I asked a Nestle rep ("Rachael") whether it was dangerous to eat raw cookie dough. The response that I got was unsurprising. "We take a very conservative approach to food handling and absolutely do NOT recommend consuming any raw product that is intended to be cooked," Rachael told me. "Just as the dough that is made and baked in your home could potentially have pathogens, so is the case with our refrigerated cookie dough. Although the egg that is used in our cookie dough is pasteurized and should not contain any pathogens, theoretically, other ingredients could." I then asked if there had been any recent cases of customer complaints in regards to eating raw cookie dough. "That information is proprietary, and we do not recommend consuming raw dough," she reiterated.
While Rivera's case was clearly a worst-case scenario, I was curious as to whether food poisoning from cookie dough continues to be commonplace. According to the CDC, one in six Americans becomes sickened with food poisoning every year, with about 3,000 deaths. And in 2011, more than 19,000 people were hospitalized with salmonella poisoning, though just 2,000 with E. coli. Salmonella topped the list that year as the number-one culprit for death by foodborne illness, but E. coli wasn't even in the top five.
I consulted Dr. Adrienne Kassis, a primary care provider at One Medical Group, to ask how worried we should be about the occasional lick of a spoon. She confirmed that while there are tens of thousands of cases of salmonella poisoning in the US each year (with most occurring in children under the age of 15), only about 1 out of every 20,000 eggs is contaminated. "Overall, the risk is low, and salmonella infections are rarely severe." She also warned that you're much more likely to get a bad case of food poisoning from undercooked meats and unpasteurized dairy products. "I have never personally experienced food poisoning from eating raw batter—and it's a habit I have indulged for my entire life," she added. "I also have never had a patient with salmonella infection from this type of ingestion."
But again, in Rivera's case, the culprit was likely not the eggs, but the flour. Maybe in a post-pasteurization world, we've been looking at the dark side of cookie dough from the wrong starting point. Or maybe, Rivera was just unlucky in the worst way.
Following the 2009 E. coli outbreak, Nestle changed their formula and added a written warning on their packaging telling consumers not to consume the dough raw. They also bolstered their testing and inspection of ingredients, and began heat-treating their flour. But the risk, although minute, can still be of dire consequence.
In a 2010 interview from her hospital bed, Rivera warned, "Don't take the chance with it. It's not worth it. You give up your life, you lose everything." Coming from her, it could be worth taking seriously—though you'll have to weigh your love of cookie dough to decide.
This article was originally published on MUNCHIES on November 17, 2014.